Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-28T01:47:09.465Z Has data issue: false hasContentIssue false
  • English
  • Français

Conventional stepwise vs. vital capacity rapid inhalation induction at two concentrations of sevoflurane

Published online by Cambridge University Press:  23 December 2004

R. Martín-Larrauri ,
F. Gilsanz ,
J. Rodrigo ,
P. Vila ,
M. Ledesma  and
C. Casimiro
R. Martín-Larrauri
Affiliation:
Hospital La Milagrosa, Department of Anaesthesiology, Madrid, Spain
F. Gilsanz
Affiliation:
Hospital La Paz, Department of Anaesthesiology, Madrid, Spain
J. Rodrigo
Affiliation:
Fundación Jiménez Díaz, Department of Anaesthesiology, Madrid, Spain
P. Vila
Affiliation:
Hospital Germans Trías i Pujol, Department of Anaesthesiology, Badalona, Spain
M. Ledesma
Affiliation:
Abbott Laboratories, Medical Department, Madrid, Spain
C. Casimiro
Affiliation:
Abbott Laboratories, Medical Department, Madrid, Spain
Get access

Extract

Summary

Background and objective: A multicentre study was conducted to compare three methods of inhalation induction with sevoflurane in adult premedicated patients.

Methods: One-hundred-and-twenty-five adult patients of ASA I–II were scheduled for short elective surgical procedures (<90 min) under general anaesthesia with spontaneous ventilation of the lungs via a laryngeal mask airway. Patients were randomly assigned to one of three groups: conventional stepwise inhalation induction group (Group C) or vital capacity rapid inhalation induction groups at 4.5% (Group VC4.5) or at 8% sevoflurane (Group VC8). Before anaesthetic induction, fentanyl 1 μg kg−1 was given and the face mask applied with the anaesthetic breathing system primed with sevoflurane 4.5% or 8% in the respective vital capacity groups. Loss of eyelash reflex, time to cessation of finger tapping, laryngeal mask insertion, side-effects and adequacy of induction were recorded.

Results: The time to loss of eyelash reflex was significantly shorter in both vital capacity groups vs. the control group: VC8: 68 ± 7 s; and VC4.5: 94 ± 6.5 s vs. C: 118 ± 6.4 s (P < 0.0001). Significant differences were found in all pairwise comparisons for time to cessation of tapping: Group VC8 (62 ± 7 s), Group VC4.5 (85 ± 6 s) and Group C (116 ± 6 s; P < 0.0001). The time to laryngeal mask insertion was significantly shorter in the Group VC8 (176 ± 13 s) compared with the other two groups, Group VC4.5 (219 ± 13 s) and Group C (216 ± 9 s). There were no significant differences in the incidence of side-effects between the three groups.

Conclusions: Inhalation induction of anaesthesia with sevoflurane with the three techniques tested is safe, reliable and well accepted by the patients. The vital capacity rapid inhalation group primed with sevoflurane 8% was the fastest method with no relevant side-effects.

Keywords

ANAESTHESIA, inhalationANAESTHETICS, INHALATION, nitrous oxideANAESTHETICS, VOLATILE, sevofluraneINTUBATION, intratracheal, laryngeal masks
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 21 , Issue 4 , April 2004 , pp. 265 - 271
Copyright
2004 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Doi M, Ikeda K. Airway irritation produced by volatile anaesthetics during brief inhalation: comparison of halothane, enflurane, isoflurane and sevoflurane. Can J Anesth 1993; 40: 122–126.Google Scholar
Goresky GV, Muir J. Inhalation induction of anaesthesia. Can J Anesth 1996; 43: 1085–1086.Google Scholar
Wong AY, Lawmin JC, Irwin MG. Anaesthetic management of a patient with low tracheal obstruction requiring placement of a T-Y stent. Anaesth Intens Care 2000; 28: 196–198.Google Scholar
Thwaites A, Edmends S, Smith I. Inhalation induction with sevoflurane: a double-bind comparison with propofol. Br J Anaesth 1997; 78: 356–361.Google Scholar
Hall JE, Stewart JIM, Harmer M. Single-breath inhalation induction of sevoflurane anaesthesia with and without nitrous oxide: a feasibility study in adults and comparison with an intravenous bolus of propofol. Anaesthesia 1997; 52: 410–415.Google Scholar
Moore EW, Davies MW. Inhalational versus intravenous induction. A survey of emergency anaesthetic practice in the United Kingdom. Eur J Anaesthesiol 2000; 17: 33–37.Google Scholar
Ruffle JM, Snider MT, Rosenberg JL, Latta WB. Rapid induction of halothane anaesthesia in man. Br J Anaesth 1985; 57: 607–611.Google Scholar
Wilton NCT, Thomas VL. Single breath induction of anaesthesia, using a vital capacity breath of halothane, nitrous oxide and oxygen. Anaesthesia 1986; 41: 472–476.Google Scholar
Sloan MH, Conard PF, Karsunky PK, Gross JB. Sevoflurane versus isoflurane: induction and recovery characteristics with single-breath inhaled inductions of anesthesia. Anesth Analg 1996; 82: 528–532.Google Scholar
Muzi M, Robinson BJ, Ebert TJ, O'Brien. Induction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology 1996; 85: 536–543.Google Scholar
Yurino M, Kimura H. A comparison of vital capacity breath and tidal breathing techniques for induction of anaesthesia with high sevoflurane concentrations in nitrous oxide and oxygen. Anaesthesia 1995; 50: 308–311.Google Scholar
Yurino M, Kimura H. Induction of anesthesia with sevoflurane, nitrous oxide, and oxygen: a comparison of spontaneous ventilation and vital capacity rapid inhalation induction (VCRII) techniques. Anesth Analg 1993; 76: 598–601.Google Scholar
Djaiani GN, Hall J, Pugh S, Peaston RT. Vital capacity inhalation induction with sevoflurane: an alternative to standard intravenous induction for patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth 2001; 15: 169–174.Google Scholar
Mendonca C, Thorpe C. Effect of smoking on induction of anaesthesia with sevoflurane. Anaesthesia 2001; 56: 19–23.Google Scholar
Hall JE, Henderson KA, Oldham TA, Pugh S, Harmer M. Environmental monitoring during gaseous induction with sevoflurane. Br J Anaesth 1997; 79: 342–345.Google Scholar
Ishii M, Nishino T, Kochi T. Changes in respiratory pattern during induction of anaesthesia with sevoflurane: comparison of nasal and oral breathing. Eur J Anaesthesiol 1966: 13: 21–26.Google Scholar
Campbell IT. Breathing routes and inhalation induction of anaesthesia. Eur J Anaesthesiol 1996; 13: 1–2.Google Scholar
Muzi M, Colinco MD, Robinson BJ, Ebert TJ. The effects of premedication on inhaled induction of anesthesia with sevoflurane. Anesth Analg 1997; 85: 1143–1148.Google Scholar
Plastow SE, Hall JE, Pugh SC. Fentanyl supplementation of sevoflurane induction of anaesthesia. Anaesthesia 2000; 55: 475–478.Google Scholar
Nishiyama T, Matsukawa T, Yokoyama T, Hanaoka K. Rapid inhalation induction with 7% sevoflurane combined with intravenous midazolam. J Clin Anesth 2002; 14: 290–295.Google Scholar
Jellish WS, Lien CA, Fontenot HJ, Hall R. The comparative effects of sevoflurane versus propofol in the induction and maintenance of anaesthesia in adult patients. Anesth Analg 1996; 82: 479–485.Google Scholar
Lien CA, Hemmings HC, Belmont MR, Abalos A, Holmann Ch, Kelly RE. A comparison: the efficacy of sevoflurane-nitrous oxide or propofol-nitrous oxide for the induction and maintenance of general anesthesia. J Clin Anesth 1966; 8: 639–643.Google Scholar
Smith I, Thwaites AJ. Inhalation versus TIVA in short duration anaesthesia. Acta Anaesth Belg 1997; 48: 161–166.Google Scholar
Yurino M, Kimura H. Vital capacity rapid inhalation induction technique: comparison of sevoflurane and halothane. Can J Anesth 1993; 40: 440–443.Google Scholar
Yurino M, Kimura H. Comparison of induction time and characteristics between sevoflurane and sevoflurane/nitrous oxide. Acta Anaesthesiol Scand 1995; 39: 356–358.Google Scholar
Yurino M, Kimura H. Efficient inspired concentration of sevoflurane for vital capacity rapid inhalation induction (VCRII) technique. J Clin Anesth 1995; 7: 228–231.Google Scholar
Hall JE, Oldham TA, Stewart, Harmer M. Comparison between halothane and sevoflurane for adult vital capacity induction. Br J Anesth 1977; 79: 285–288.Google Scholar
Vanacker BF. Sevoflurane mask induction in adults: comparison of two inhalation techniques. Acta Anaesth Belg 1997; 48: 147–153.Google Scholar
Philip BK, Lombard LL, Edward RR, Drager LR, Calalang I, Philip JH. Comparison of vital capacity induction with sevoflurane to intravenous induction with propofol for adult ambulatory anesthesia. Anesth Analg 1999; 89: 623–627.Google Scholar
Smith CE, Lever JS, Sawkar S, Pinchak AC, Hagen JF. Sevoflurane-N2O versus propofol/isoflurane-N2O during elective surgery using the laryngeal mask airway in adults. J Clin Anesth 2000; 12: 392–396.Google Scholar
Hendrickx JF, Vandeput DM, De Geyndt AM, De Loof T, De Wolf AM. Coasting after overpressure induction with sevoflurane. J Clin Anesth 2000; 12: 100–103.Google Scholar
Baker CE, Smith I. Sevoflurane: a comparison between vital capacity and tidal breathing techniques for the induction of anaesthesia and laryngeal mask airway placement. Anaesthesia 1999; 54: 841–844.Google Scholar
Nishiyama T, Aibiki M, Hanaoka K. Haemodynamic and catecholamine changes during rapid sevoflurane induction with tidal volume breathing. Can J Anesth 1977; 44: 1066–1070.Google Scholar
Hall JE, Ebert TJ, Harmer M. Induction characteristics with 3% and 8% sevoflurane in adults: an evaluation of the second stage of anaesthesia and its haemodynamic consequences. Anaesthesia 2000; 55: 545–550.Google Scholar